What are the responsibilities and job description for the Medical Billing Specialist position at ST. CHARLES SURGICAL HOSPITAL?
Overview
We are seeking a dedicated and detail-oriented Hospital/Physician Biller to join our healthcare team. This is a part-time temporary position to support maternity leave. The ideal candidate will possess a comprehensive understanding of medical coding and billing processes, with expertise in various coding systems such as DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology), ICD-9, and ICD-10. This role is crucial in ensuring accurate medical record management and compliance with healthcare regulations while contributing to the overall efficiency of hospital operations.
Duties
- Maintains responsibility for the timely submission of all hospital and physician claims
- Works daily electronic billing files and submits insurance claims to third-party payers; reviews daily edit reports from the hospital billing system and makes necessary corrections to allow electronic submission.
- Reviews error reports from electronic payers; identifies errors and makes appropriate corrections to ensure accurate claim submission.
- Prepares and submits manual insurance claims to third-party payers who do not accept electronic claims or who require special handling.
- Documents activity on the patient account ensures hospital compliance with all state and federal billing regulations and reports any suspected compliance issues to the Billing Manager and/or Supervisor.
- Works denials in Practice Plus, Thrive, Trubridge and TriZetto to ensure claims are processed timely.
- Index scanned documents for the department
- Assist with other revenue cycle duties as needed
- Acts in accordance with mission and values, while serving as a role model for ethical behavior
- Adheres to federal and state regulations related to the protection of patient information (e.g., the Health Insurance Portability and Accountability Act (HIPAA) as well as facility-specific guidelines
- Other duties as assigned
Requirements
- Coding Certification (CPC, CCS, CCA, COC, CBCS or CRC from AHIMA or AAPC) preferred
- Min Two years' experience in a healthcare environment, particularly in healthcare billing, collections, payment processing or denial management.
- Strong attention to detail and problem solving
- Experience working with the Electronic medical records
- Familiar with insurance claims and appeal process
- Excellent communication and interpersonal skills
- Able to work independently and manage a high volume of claims and tasks
- Familiarity with EMR and EHR systems for efficient management of patient records.
Work Location: In person